Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective Study
Background: Hematoma expansion (HE) is a significant predictor of poor outcomes in patients with intracerebral hemorrhage (ICH). Non-contrast computed tomography (NCCT) markers in ICH are promising predictors of HE. We aimed to determine the association of the NCCT markers with HE by using different...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
|
| Series: | Brain Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3425/13/4/608 |
| _version_ | 1797606138339917824 |
|---|---|
| author | Lianghong Yu Mingpei Zhao Yuanxiang Lin Jiateng Zeng Qiu He Yan Zheng Ke Ma Fuxin Lin Dezhi Kang |
| author_facet | Lianghong Yu Mingpei Zhao Yuanxiang Lin Jiateng Zeng Qiu He Yan Zheng Ke Ma Fuxin Lin Dezhi Kang |
| author_sort | Lianghong Yu |
| collection | DOAJ |
| description | Background: Hematoma expansion (HE) is a significant predictor of poor outcomes in patients with intracerebral hemorrhage (ICH). Non-contrast computed tomography (NCCT) markers in ICH are promising predictors of HE. We aimed to determine the association of the NCCT markers with HE by using different temporal HE definitions. Methods: We utilized Risa-MIS-ICH trial data (risk stratification and minimally invasive surgery in acute intracerebral hemorrhage). We defined four HE types based on the time to baseline CT (BCT) and the time to follow-up CT (FCT). Hematoma volume was measured by software with a semi-automatic edge detection tool. HE was defined as a follow-up CT hematoma volume increase of >6 mL or a 33% hematoma volume increase relative to the baseline CT. Multivariable regression analyses were used to determine the HE parameters. The prediction potential of indicators for HE was evaluated using receiver-operating characteristic analysis. Results: The study enrolled 158 patients in total. The time to baseline CT was independently associated with HE in one type (odds ratio (OR) 0.234, 95% confidence interval (CI) 0.077–0.712, <i>p</i> = 0.011), and the blend sign was independently associated with HE in two types (OR, 6.203–6.985, both <i>p</i> < 0.05). Heterogeneous density was independently associated with HE in all types (OR, 6.465–88.445, all <i>p</i> < 0.05) and was the optimal type for prediction, with an area under the curve of 0.674 (<i>p</i> = 0.004), a sensitivity of 38.9%, and specificity of 96.0%. Conclusion: In specific subtypes, the time to baseline CT, blend sign, and heterogeneous density were independently associated with HE. The association between NCCT markers and HE is influenced by the temporal definition of HE. Heterogeneous density is a stable and robust predictor of HE in different subtypes of hematoma expansion. |
| first_indexed | 2024-03-11T05:11:03Z |
| format | Article |
| id | doaj.art-69dcf6d7424d4ce787e5a92440e9eb5c |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-11T05:11:03Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-69dcf6d7424d4ce787e5a92440e9eb5c2023-11-17T18:32:35ZengMDPI AGBrain Sciences2076-34252023-04-0113460810.3390/brainsci13040608Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective StudyLianghong Yu0Mingpei Zhao1Yuanxiang Lin2Jiateng Zeng3Qiu He4Yan Zheng5Ke Ma6Fuxin Lin7Dezhi Kang8Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaClinical Research and Translation Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, ChinaBackground: Hematoma expansion (HE) is a significant predictor of poor outcomes in patients with intracerebral hemorrhage (ICH). Non-contrast computed tomography (NCCT) markers in ICH are promising predictors of HE. We aimed to determine the association of the NCCT markers with HE by using different temporal HE definitions. Methods: We utilized Risa-MIS-ICH trial data (risk stratification and minimally invasive surgery in acute intracerebral hemorrhage). We defined four HE types based on the time to baseline CT (BCT) and the time to follow-up CT (FCT). Hematoma volume was measured by software with a semi-automatic edge detection tool. HE was defined as a follow-up CT hematoma volume increase of >6 mL or a 33% hematoma volume increase relative to the baseline CT. Multivariable regression analyses were used to determine the HE parameters. The prediction potential of indicators for HE was evaluated using receiver-operating characteristic analysis. Results: The study enrolled 158 patients in total. The time to baseline CT was independently associated with HE in one type (odds ratio (OR) 0.234, 95% confidence interval (CI) 0.077–0.712, <i>p</i> = 0.011), and the blend sign was independently associated with HE in two types (OR, 6.203–6.985, both <i>p</i> < 0.05). Heterogeneous density was independently associated with HE in all types (OR, 6.465–88.445, all <i>p</i> < 0.05) and was the optimal type for prediction, with an area under the curve of 0.674 (<i>p</i> = 0.004), a sensitivity of 38.9%, and specificity of 96.0%. Conclusion: In specific subtypes, the time to baseline CT, blend sign, and heterogeneous density were independently associated with HE. The association between NCCT markers and HE is influenced by the temporal definition of HE. Heterogeneous density is a stable and robust predictor of HE in different subtypes of hematoma expansion.https://www.mdpi.com/2076-3425/13/4/608intracerebral hemorrhagehematoma expansionhematoma heterogeneitydensity categories of heterogeneousnon-contrast computed tomographystroke |
| spellingShingle | Lianghong Yu Mingpei Zhao Yuanxiang Lin Jiateng Zeng Qiu He Yan Zheng Ke Ma Fuxin Lin Dezhi Kang Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective Study Brain Sciences intracerebral hemorrhage hematoma expansion hematoma heterogeneity density categories of heterogeneous non-contrast computed tomography stroke |
| title | Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective Study |
| title_full | Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective Study |
| title_fullStr | Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective Study |
| title_full_unstemmed | Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective Study |
| title_short | Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective Study |
| title_sort | noncontrast computed tomography markers associated with hematoma expansion analysis of a multicenter retrospective study |
| topic | intracerebral hemorrhage hematoma expansion hematoma heterogeneity density categories of heterogeneous non-contrast computed tomography stroke |
| url | https://www.mdpi.com/2076-3425/13/4/608 |
| work_keys_str_mv | AT lianghongyu noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy AT mingpeizhao noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy AT yuanxianglin noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy AT jiatengzeng noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy AT qiuhe noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy AT yanzheng noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy AT kema noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy AT fuxinlin noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy AT dezhikang noncontrastcomputedtomographymarkersassociatedwithhematomaexpansionanalysisofamulticenterretrospectivestudy |